Phenotypic overlap of mental health impairment in post-COVID condition and depressive disorders: Insights from the DigiHero cohort.

BACKGROUND

Post-COVID condition (PCC) has been linked to substantial mental health impairment. However, a comprehensive and dimensional understanding of the specific mental health impairments associated with PCC is still missing. Therefore, we aimed to (1) profile PCC-related symptoms using a dimensional approach and (2) evaluate their phenotypic overlap with lifetime depression.

METHODS

Data from 10,938 participants of the German population-based DigiHero cohort were analysed. PCC was defined by the presence of ≥1 new symptoms persisting ≥12 weeks after SARS-CoV-2 infection. Lifetime depression was based on self-reported diagnosis of depression made by a physician. A total of 45 mental health variables from 17 validated instruments covering a broad spectrum of mental health dimensions were analysed.

RESULTS

Of the 45 assessed mental health indicators, 35 differed significantly between individuals with (n = 1984) and without (n = 8954) PCC, with the largest effect sizes (Cliff's delta) for exhaustion, fatigue, tiredness, impaired task completion, elevated tension, and nervousness, as well as reduced resilience, life satisfaction, and energy, in PCC patients. Cognitive complaints, including working memory difficulties, were also associated with PCC. Furthermore, compared with the Depression only group (n = 1184), the PCC only group (n = 1532) showed lower levels of recovery time, worrying, anhedonia, feeling depressed, feeling worthless, nervousness, and shame, as well as higher resilience and determination.

CONCLUSIONS

Our findings describe mental health symptom patterns associated with PCC in a large population-based cohort and highlight differences in fatigue-related, cognitive, and affective symptoms compared with individuals without PCC and those with lifetime depression.